Medicine: Death at a New York Hospital by Englebert L. Schucking
Introduction
Discussion of advanced directives
Advance directive when applied to health care encompasses a number of legislations giving rights to relatives or surrogates to make medical decisions if a patent is incapable of doing so. It includes policies underlying the execution of Living wills; personal directives; advance directives and advance decisions (Scoy, 2011).
Scoy (2011) a renowned physician, however, argues that while all these directives are well meaning; in the Medical professions at a time when decisions have to be made concerning critical issues pertaining to life of the patient they are inadequate. This was being voiced from the perspective of them unable to answer questions asked by physicians regarding identity and personal philosophy of the client prior to the medical emergency which are essential elements of emergency care (Scoy, 2011)
An example of this has been depicted in the story relating, death of 53 year old Editor Brenda Hewitt. Her care giver and long time confidant felt that she had it all covered, but realized the limitation of the documents she was carrying when she was consistently debarred from even entering the ICU, initially (Schucking, 1983)
Patient Self-Determination Act
This act came into Law December 1st; 1991.It specifies the responsibility of Nursing Homes, Hospitals; Hospice service providers; Home Health Aids Agencies and HMO to provide the relevant information to patients and their relatives pertaining to the option of Advance Health Care directives. Doctors in private practice are exempt form this law since it was designed for health care institutions as a body and not a service (Leahman, 2004)
The main reason for this legal intervention was for patients to be knowledgeable concerning their rights to make their own health care decisions when incapable of doing so in an emergency; their rights to accept or refuse such care they deem irrelevant or detrimental based on a personal philosophy or culture and the right to make this in advance (Leahman, 2004)
Living Will
A Living will is actually the legislation that stipulates what the patient desires in cases of emergency in reference to their medical care. Some people do not want to be r4resusitated and this I stated in a living will. It is considered an advance health care directive.
Durable Power of Attorney for Healthcare
Durable power of attorney can be considered an extension of a regular power of attorney granting another person permission of representation in one’s absence. Usually, if the grantor dies or becomes incapable of making decisions it becomes invalid. However, a durable power of attorney is active beyond the confines of incapacitation and death.
Conclusion --Opinion
The story highlighted for this discussion, ‘Death at a New York Hospital by Englebert L. Schucking’ creates sensitivity as to how effective advance directives through the Self Determination Act can be. In the case of Brenda Hewitt no one is sure whether her life could have been prolonged had she taken the relevant advance directive measures documented exactly her philosophy regarding the procedures doctors were carrying out and proposing to do.
It could be concluded, anyway, that with legal intervention the quality of care could have been improved during the end of life experiences when she not verbally accept neither refuse the treatment.
References
Leahman D (2004). "Why the Patient Self-Determination Act has failed". N C Med J 65 (4):
249–51.
Schucking Englebert (1983). Death at a New York Hospital, New York:
Scoy, Van Jodi Lauren (2011).Living with Dying: An Advance Directive Alone is not enough.
New York: Death with Dignity National Center.
